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Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report (2016)

Chapter: Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks

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Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
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TABLE R-1 Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks

Database Summary Data Collection Relevant Outcomes
NHANES: National Health and Nutrition Examination Survey (USDA/ARS, 2005–2008, 2011–2012)

Nationwide data collected annually from 1999–2014

20,000–50,000 individuals of all ages each cycle

Sample sizes and design differ across cycles of NHANES

NHANES 1999–2006 oversampled Hispanics, pregnant women, and adolescents

Household screener, an interview, and an examination

Interview: person-level demographic, health, and nutrition information, information about the household

Examination: physical measurements such as blood pressure, dental examination, plus blood and urine specimens for laboratory testing

Dietary survey: 24-hour recalls with the USDA Automated Multiple-Pass Method

Women: Prevalence of diabetes, visual impairment, iron deficiency anemia, low serum, and RBC folate

Children: Prevalence of child obesity and overweight, underweight, and iron deficiency anemia in children

Dietary intake for women and children

WIC ITFPS-2 Infant Report: Intention to Breastfeed (May et al., 2015)

Longitudinal study from 1994–2013 measuring feeding practices employed by caregivers and the nutrition outcomes of children who participate in WIC

Captures data on caregivers and children over the first 3 years of the child’s life

Screening and enrollment interviews with WIC enrollees, telephone follow-up interviews, WIC administrative records, site visits and key informants interviews, and WIC site staff survey

Prenatal views on breastfeeding

Pre-pregnancy weight status

Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Database Summary Data Collection Relevant Outcomes
NIS: National Immunization Survey (CDC, 2015a) Retrospective national breastfeeding data collected annually from 2001 to 2013 on children 19 to 35 months of age List-assisted random-digit-dialing telephone survey followed by a mailed survey to children’s immunization providers. Breastfeeding questions posed to mothers are retrospective Breastfeeding initiation, duration, and exclusivity

PC 2008 and 2012: WIC Participant and Program Characteristics 2008 and 2012 (USDA/FNS, 2010, 2013)

National WIC participant data collected by FNS and published in reports every 2 years starting in 1984

Anthropometric data from NCHS

Cutoff values are according to FNS-issued nutrition risk criteria

The Minimum Data Set provided by states to FNS consists of 20 items

Maternal weight status by pregnancy and breastfeeding status, prevalence of anemia, prevalence of overweight in children 2 years and older, growth outcomes, underweight in children, low birth weight, or premature birth

PNSS: Pregnancy Nutrition Surveillance System (CDC, 2011a)

WIC program data from 29 states, the District of Columbia, 3 ITOs, and 1 U.S. territory

Discontinued after 2011

Data collected at the clinic level, aggregated at the state level, then submitted to CDC for analysis

Demographic data: maternal age, race and ethnicity, education level, household income, migrant status, and participation in food and medical assistance programs

Women: height/ weight before, during, and after pregnancy; hemoglobin and hematocrit levels; parity; medical care during pregnancy; and enrollment in WIC

Prevalence of prepregnancy overweight and obesity, maternal weight gain greater than ideal, gestational diabetes, 3rd trimester anemia, and postpartum anemia

Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Database Summary Data Collection Relevant Outcomes
PedNSS: Pediatric Nutrition Surveillance System (CDC, 2011b) WIC program (87.5 percent) and other programs (12.5 percent) data from 46 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and 6 ITOs Children: birthweight, anemia, breastfeeding, short stature, underweight, overweight, and obesity

Prevalence of obesity and overweight for children < 5 years and 2 years

Prevalence of underweight and short stature for children < 5 years

Discontinued after 2011 Prevalence of anemia for children 5 years
Data collected at the clinic level, aggregated at the state level, then submitted to CDC for analysis Prevalence of very low birth weight, low birth weight, normal birth weight, high birth weight, preterm birth, full-term low birth weight, and multiple births
NATFAN: National Food and Nutrition Questionnaire—WIC Food Package Revisions (Texas A&M, 2013) National multiyear, multilevel study to examine participant food and nutrition behavior before and after implementation of the revisions in the WIC food package (FY 2009, FY 2010, and early 2011) Food choice questionnaires and frequency instruments developed specifically for WIC participants. Involved state, territorial, tribal, and local WIC programs Data not used in this review due to convenience sampling
Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Database Summary Data Collection Relevant Outcomes
PRAMS: Pregnancy Risk Assessment Monitoring System (CDC, 2015b) Data from state birth certificates for 40 states, self-reported data from samples of 1,300–3,400 women per state per year, from 1988–2009 Mailed questionnaire with multiple followups by mail and telephone Questions: Barriers to and content of prenatal care, obstetric history, maternal use of alcohol and cigarettes, physical abuse, contraception, economic status, maternal stress, and early infant development and health status Prevalence of prepregnancy obesity in 2009 for women ages 20+, gestational diabetes in 2010
Ross Laboratories Mothers Survey (Ryan, 2005)

Large prospective national survey conducted by infant formula manufacturer Ross Laboratories. Nearly 1 million surveys sent annually

Data collection from 1971–2003

Monthly questionnaires sent to mothers when infants reached 1 month, 2 months, and so on up to 12 months. Breastfeeding initiation measured by in-hospital rates Breastfeeding initiation and exclusivity

NOTE: CDC = Centers for Disease Control and Prevention; FNS = Food and Nutrition Service; FY = fiscal year; ITFPS = Infant and Toddler Feeding Practices Study; ITO = Indian Tribal Organization; NCHS = National Center for Health Statistics; RBC = red blood cell.

Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×

REFERENCES

CDC (Centers for Disease Control and Prevention). 2011a. Pregnancy Nutrition Surveillance System. http://www.cdc.gov/pednss/what_is/pnss (accessed June 1, 2015).

CDC. 2011b. Pediatric Nutrition Surveillance System. http://www.cdc.gov/pednss/what_is/pednss/index.htm (accessed June 1, 2015).

CDC. 2015a. National Immunization Survey. http://www.cdc.gov/nchs/nis.htm (accessed June 2, 2015).

CDC. 2015b. Pregnancy Risk Assessment Monitoring System. http://www.cdc.gov/prams (accessed June 1, 2015).

May, L., C. Borger, S. McNutt, G. Harrison, N. Weinfield, C. MacAllum, and J. Montaquila. 2015. WIC ITFPS-2 infant report: Intention to breastfeed. Rockville, MD: Westat. http://www.fns.usda.gov/sites/default/files/ops/WICITFPS2-Prenatal.pdf (accessed June 1, 2015).

Ryan, A. S. 2005. More about the Ross Mothers Survey. Pediatrics 115(5):1450-1451.

Texas A&M University Institute for Obesity Research and Program Evaluation. 2013. National Food and Nutrition (NATFAN) questionnaire—WIC food package revisions. http://orin.tamu.edu/research/natfan/ (accessed May 18, 2015).

USDA/ARS (U.S. Department of Agriculture/Agricultural Research Service). 2005–2008. What we eat in America, NHANES 2005–2008. Beltsville, MD: USDA/ARS (accessed December 15, 2014).

USDA/ARS. 2011–2012. What we eat in America, NHANES 2011–2012. Beltsville, MD: USDA/ARS. (accessed December 15, 2014).

USDA/FNS (U.S. Department of Agriculture/Food and Nutrition Service). 2010. WIC participant and program characteristics 2008. Alexandria, VA: USDA/FNS. http://www.fns.usda.gov/sites/default/files/pc2008_0.pdf (accessed April 2, 2015).

USDA/FNS. 2013. WIC participant and program characteristics 2012 final report. Alexandria, VA: USDA/FNS. http://www.fns.usda.gov/sites/default/files/WICPC2012.pdf (accessed December 20, 2014).

Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 523
Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 524
Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 525
Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 526
Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 527
Suggested Citation:"Appendix R: Summary of National Dataset Characteristics Applied in the Evaluation of Health Risks." National Academies of Sciences, Engineering, and Medicine. 2016. Review of WIC Food Packages: Proposed Framework for Revisions: Interim Report. Washington, DC: The National Academies Press. doi: 10.17226/21832.
×
Page 528
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The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began 40 years ago as a pilot program and has since grown to serve over 8 million pregnant women, and mothers of and their infants and young children. Today the program serves more than a quarter of the pregnant women and half of the infants in the United States, at an annual cost of about $6.2 billion. Through its contribution to the nutritional needs of pregnant, breastfeeding, and post-partum women; infants; and children under 5 years of age; this federally supported nutrition assistance program is integral to meeting national nutrition policy goals for a significant portion of the U.S. population.

To assure the continued success of the WIC, Congress mandated that the Food and Nutrition Service of the U.S. Department of Agriculture (USDA) reevaluate the program's food packages every 10 years. In 2014, the USDA asked the Institute of Medicine to undertake this reevaluation to ensure continued alignment with the goals of the Dietary Guidelines for Americans. This, the second report of this series, provides a summary of the work of phase I of the study, and serves as the analytical underpinning for phase II in which the committee will report its final conclusions and recommendations.

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